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Open Access Development of a Silver Diamine Fluoride Protocol in Safety Net Dental Settings

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This article is Open Access under the terms of the Creative Commons CC BY licence.

Purpose: In the United States, silver diamine fluoride (SDF) is a new method to arrest dental caries. Protocols for using SDF are under development as the research evolves and experience is gained with different populations and settings. The purpose of this study was to develop a comprehensive SDF protocol for young children tailored to safety net dental clinics (SNDCs).
Methods: We developed the SDF protocol for SNDCs through a two-step process: (1) an expert panel of pediatric dentists reviewed, modified, and expanded existing SDF protocols including clinical, pre- and post-clinical components; and (2) the new SDF protocol was implemented in three SNDCs in North Carolina with on-site didactic training, clinical observations and discussion. We obtained feedback from SNDC dentists, staff, and administrators to further refine the SDF protocol.
Results: The SDF protocol was tailored to SNDCs based on recommendations from SNDCs themselves. Suggested improvements were primarily non-clinical in nature, such as the provision of laminated SDF information with color pictures of staining in each operatory, a timer for SDF procedure, and templates for documentation, coding, and billing.
Conclusion: To facilitate SDF use in SNDCs, we developed an expert-consensus protocol that incorporated the clinical experience of SNDCs that implemented the protocol. (J Dent Child 2019;86(1):32-9)
Received September 17, 2018; Last Revision November 7, 2018; Accepted November 7, 2018.

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Keywords: DELIVERY OF HEALTH CARE; DENTAL CARIES; DENTAL CLINICS; HEALTH SERVICES RESEARCH; ORAL HEALTH; SILVER DIAMINE FLUORIDE

Document Type: Research Article

Affiliations: 1: Assistant professor, Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa., and a research fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA, Email: [email protected] 2: Alumni distinguished professor, Department of Dental Ecology, School of Dentistry, and an adjunct professor, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA 3: Assistant professor, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA 4: research assistant, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA 5: Associate professor, Department of Health Policy and Management, Gillings School of Global Public Health, and Associate Professor, Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA

Publication date: January 1, 2019

More about this publication?
  • Acquired after the merger between the American Society of Dentistry for Children and the American Academy of Pediatric Dentistry in 2002, the Journal of Dentistry for Children (JDC) is an internationally renowned journal whose publishing dates back to 1934. Published three times a year, JDC promotes the practice, education and research specifically related to the specialty of pediatric dentistry. It covers a wide range of topics related to the clinical care of children, from clinical techniques of daily importance to the practitioner, to studies on child behavior and growth and development. JDC also provides information on the physical, psychological and emotional conditions of children as they relate to and affect their dental health.
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